Medical student attention to preventive medicine: change with time and reinforcement

We followed medical students' attention to documentation in their write-ups of appropriate preventive medicine information, based upon a patient's age, sex, and existing medical conditions, as well as the translation of critical findings to the problem list, for three years. The proportion of relevant items documented was .50 in year one, .80 in year two, and .69 in year three. Significant differences (p less than .001) were found between all three years. Similarly, the proportion of important items translated to the problem list was .04 in year one, .22 in year two, and .18 in year three. There was significant improvement in years two and three as compared to year one (p less than .001). The impact of interventions designed to reinforce the medical student's attention to preventive medicine was also studied. Cued forms on which to record the patient's history were compared to written feedback regarding the student's write-ups. Both significantly improved student performance. The effect of the written feedback also persisted in the follow-up period.